Department of Pediatric Surgery, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, 6 Weizmann St., Tel Aviv 6423906, Israel.
Department of Pediatric Gastroenterology, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, 6 Weizmann St., Tel Aviv 6423906, Israel.
Nutrients. 2023 Jun 21;15(13):2826. doi: 10.3390/nu15132826.
Essential amino acids (AAs) play a key role in stimulating intestinal adaptation after massive small gut resection. The nutritional effect of dietary amino acids during intestinal regrowth has received considerable attention in recent years. This review explores the significance of dietary amino acids in the nutritional management of infants and children with intestinal failure and short bowel syndrome (SBS) as reported in the medical literature over the last three decades. A literature search was conducted using electronic databases. Breast milk emerged as the first-line enteral regimen recommended for infants with SBS. Hydrolyzed formulas (HFs) or amino acid formulas (AAFs) are recommended when breast milk is not available or if the infant cannot tolerate whole protein milk. The superiority of AAFs over HFs has never been demonstrated. Although glutamine (GLN) is the main fuel for enterocytes, GLN supplementation in infants with SBS showed no difference in the child's dependence upon parenteral nutrition (PN). Circulating citrulline is considered a major determinant of survival and nutritional prognosis of SBS patients. Early enteral nutrition and dietary supplementation of AAs following bowel resection in children are essential for the development of intestinal adaptation, thereby eliminating the need for PN.
必需氨基酸（AAs）在小肠大量切除后刺激肠道适应中发挥着关键作用。近年来，人们对肠道再生期间饮食氨基酸的营养作用给予了相当的关注。本文综述了过去三十年医学文献中报道的饮食氨基酸在治疗肠道衰竭和短肠综合征（SBS）患儿中的营养管理中的重要性。使用电子数据库进行了文献检索。对于 SBS 婴儿，母乳被认为是首选的肠内治疗方案。如果没有母乳或婴儿不能耐受全蛋白奶，则推荐使用水解配方（HF）或氨基酸配方（AAF）。AAF 优于 HF 从未得到证实。尽管谷氨酰胺（GLN）是肠细胞的主要燃料，但 SBS 婴儿的 GLN 补充在患儿对肠外营养（PN）的依赖方面没有差异。循环瓜氨酸被认为是 SBS 患者生存和营养预后的主要决定因素。儿童肠切除术后早期肠内营养和饮食补充氨基酸对于肠道适应的发展至关重要，从而消除了对 PN 的需求。
